AHRQ State Snapshots Bolster Medicaid Legislation

Prevention and Care Management

2009

The New York State Department of Health used the AHRQ State Snapshots—a national benchmark for measuring the quality of care—to support recently passed legislation to improve primary and preventive care that provides patient self-management programs to Medicaid recipients.

Foster Gesten, MD, Medical Director of the Office of Health Insurance Programs in the New York State Department of Health, learned about the Snapshots through his participation in the AHRQ-sponsored Medicaid Medical Directors Learning Network. Gesten says, "I can't overemphasize the importance of objective measures that enable us to benchmark our results to the national average. While sometimes challenging, the data presented in the Snapshots can serve to more objectively assess both our strengths and weaknesses. It can direct and motivate change, as it has in New York."

The State Snapshots provide an annual analysis that identifies areas of strength and weakness in each State's health care delivery system as compared to all States, to its region, or to the best-performing State. This web tool reports on over 150 different measures of health care quality for each State.

Compared to other States, New York is in the "weak" range for overall health care quality, as reported in the 2007 State Snapshot. New York's weakest measures include relatively high rates of hospital admissions for children with asthma, relatively high rates of hospital admissions for adults with diabetes having long-term complications, and relatively high rates of hospital admissions for adults with uncontrolled diabetes without complications.

New York's strongest measures include a relatively high rate for the percentage of short-stay nursing home residents who were assessed and given pneumococcal vaccination and a relatively low rate for the percentage of deaths among infants without low birth weight.

Gesten notes that over the past couple of years, New York State Medicaid officials have been assessing the State's strengths and weaknesses relative to national data to determine what their programmatic and budget priorities should be. They are particularly focused on health care quality, but also looking at health care costs, outcomes, and general health.

The 2007 State Snapshots' composite measures of clinical care further indicate that New York State has room to improve in diabetes and asthma care, both having scored within the weak range. Gesten says that he used New York's State Snapshot as "a general clarion call that all is not well in the State."

In particular, the State Snapshots information, as well as AHRQ's Prevention Quality Indicator scores using Healthcare Cost and Utilization Project data, were used to make a case, "that the data supports our need to make an investment to improve primary care and preventive care in the ambulatory setting." According to Gesten, such educational efforts resulted in legislative reforms that will provide self-management education for Medicaid patients with diabetes and asthma.